# Republicans: Please Define Health Care Reform **URL:** \ **Category:** Great Debates\ **Created:** [January 21, 2010, 1:17am UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777 "2010-01-21T01:17:04Z")\ **Posts on this page:** 20\ **Page:** 8
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [January 21, 2010, 10:14pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/141 "2010-01-21T22:14:49Z")
> [@kunilou](#): > > **Sateryn** – forgive me for putting words in your mouth, but you seem to suggest that the solution to health care is that employers should make insurance available to their employees, and that a rational person concerned about health care should accept employment only from those organizations. > > Does that mean you expect employers to provide health insurance? Since, under your solution, employers are the gateway to health care, should all employers be required to provide insurance? If so, how would you answer \*\*Desert Nomad’s \*\*concerns? I’d love to have been able to offer insurance to potential employees - since I’d get said insurance as well for my wife and I. But at $4,700 for just the two of us, and another $700 to add a (perfectly healthy, never-been-sick-ever) employee, it just isn’t going to happen. It was far easier to leave America and hire a foreigner (who gets insurance from his national insurance system), then buy insurance for my wife and I on the private market (which we did - we pay $200/mo - not valid in the USA). When I can buy full insurance in the USA for what I pay here, I’ll move home. ---
**Author:** ![magellan01](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@magellan01](https://boards.straightdope.com/u/magellan01)\ **Post date:** [January 21, 2010, 10:23pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/142 "2010-01-21T22:23:02Z")
> [@ElvisL1ves](#): > > No, I’m asking for anything more than the simple “No” that the Republicans have limited their “contribution” to. Anything at all other than that would be substantive. From [here:](http://www.republican-leadership.com/node/751) > [@](#): > > Some Republicans in Congress have come up with reform plans, even “fundamental changes.” > > But hardly anyone knows about them - partly, no doubt, because the media have ignored them. But it’s also because Republicans hardly ever mention them. > > Moreover, in Congressional committee voting so far, while Republicans have offered amendments to Democratic proposals that indicate GOP thinking, they’ve not offered fully developed substitute plans that have been “scored” by the Congressional Budget Office. > > Two interesting GOP proposals, so far not adopted by party leaders, have been offered from opposite ends of the Republican ideological spectrum - conservative and moderate. > [@](#): > > The conservative health care proposal has been offered in the House by Rep. Paul Ryan (Wis.) and in the Senate by Richard Burr (N.C.) and Tom Coburn (Okla.). > > The moderate plan has been proposed by Reps. Mark Kirk (Ill.) and Charlie Dent (Pa.) and reportedly will form the basis of a full-blown GOP alternative developed by the GOP Health Care Solutions Group headed by Rep. Roy Blunt (Mo.), but not yet unveiled. > > The Ryan-Burr proposal would allow employees to opt out of their employer-based insurance plan and get a $5,000-per-family tax credit to buy health insurance or pay medical bills. > > It would also allow individuals and businesses to form pools and buy insurance anywhere in the country, not just in the state where they live. > > As Ryan puts it, “This will greatly expand the choices of coverage available to consumers and will also encourage broader competition and diversity among insurers.” > > Along with practically every other plan, Democratic and Republican, the conservative plan would require insurance companies to offer insurance regardless of a person’s pre-existing medical condition. > > Meantime, Kirk and Dent’s Medical Rights and Reform Act is designed to lower the cost of insurance policies through legal reform - which will reduce the expensive practice of “defensive medicine” - and also create interstate pools. > > According to Kirk, the average cost of insurance in states like California, which have limits on medical malpractice awards and allow large-scale pooling, is less than half that in lawyer-friendly states like New Jersey. > > Both the conservative and moderate plans would allow low-income Medicaid patients to get vouchers to buy private insurance and encourage states to experiment with insurance market reforms. > > Besides these proposals, other Republicans are cosponsoring bipartisan alternatives to Obama-Democratic plans, notably the Healthy Americans Act co-sponsored by Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah). > [@](#): > > Democrats may want to ignore Republican ideas and label the GOP “the party of no,” but they’d have a harder time if the GOP were more assertive in pushing its positive ideas. Moreover, voters might think better of Republicans. [Here is a side-by-side comparison offered by Reps either in part or in whole.](http://www.kff.org/healthreform/sidebyside.cfm) (Oops, the table I generated won’t link. You have to generate it yourself after you select the options. The point is that 4 of the proposals are Republican, at least in part.) And here is [an article](http://newsbusters.org/blogs/lachlan-markay/2009/09/13/media-myth-gop-has-no-health-care-ideas) that highlights some of the Rep involvement up until September. > [@ElvisL1ves](#): > > And so may those things. So which set should we try first, hmm? How about we try first those things that won’t add cost and/or dramatically alter the health care system we have? Seriously, why would you not do that _first_? > [@ElvisL1ves](#): > > Because, essentially, your proposal is imaginary. Your party has refused to advance it or even consider it. Maybe you should try convincing the other party to include it and promise to support the package as a result? See above. Or feel free to Google on your own. ---
**Author:** ![saoirse](https://avatars.discourse-cdn.com/v4/letter/s/5daacb/32.png) [@saoirse](https://boards.straightdope.com/u/saoirse)\ **Post date:** [January 21, 2010, 10:34pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/143 "2010-01-21T22:34:26Z")
> [@yorick73](#): > > And economics? Are you familiar with supply and demand? If you can show me some numbers, I’d be glad to look at them. I think you might like to read [Dr Gawande’s piece](http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all), which I clinked to above in the trhead, though. He actually looks at what causes overutilization, instead of just speculating about it. Incidentally, I used to work for an HMO, for almost five years, in Co-Ordination of Benefits and then in Marketing. My experience bears out what he says. > [@](#): > > Okay, for the last time, if you can purchase insurance ACROSS state lines then companies will have to compete and costs will decrease as compared to the system we now have. Why do you think there will only be 3 or 4 companies left? Then, for the last time, providers will be swamped by insurers sending reps out to try to convince them to carry, just like pharmaceutical companies try to get them to prescribe. > [@](#): > > And, of course consumers can make informed choices concerning health insurance. What is the roadblock to this? Start with the basics and work your way up to what you can afford. Catastrophic coverage…check. Do I really need a plan that pays for my annual checkup? Nope. See, not that difficult. You have no way of predicting what sort of medical care you’ll need throughout your contract, though. Do you need a high or low co-pay for prescriptions? Well, high, obviously, until you find that you need some maintenance prescription. Specialist visits? Referral procedures? You can’t say because you have no way of predicting what sort of illness or injury might come your way. ---
**Author:** ![Clothahump](https://avatars.discourse-cdn.com/v4/letter/c/51bf81/32.png) [@Clothahump](https://boards.straightdope.com/u/Clothahump)\ **Post date:** [January 21, 2010, 10:55pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/144 "2010-01-21T22:55:21Z")
> [@Euphonious\_Polemic](#): > > I find your language interesting. You say that you don’t want “society” to pay for everyone’s care when they’re sick. You use loaded words like "entitled and “demand”. Interesting choices. > > How about putting it as “everyone should be able to have health insurance that is reasonably priced, and one way to get this is to have the government have a major role in providing this insurance”. Sure it does not have the same catchy ring as “don’t want society to pay for some other guy”, but… > > Really, it seems that many in the US are willing to NOT do what is in the best interest of society as a whole… as long as THEY are OK. Screw the good of the country as a whole… what about MEEEEE! That is incorrect. If you can show us a way to provide health insurance to everyone that does NOT require John to pay Joe’s premiums, either directly or because John is taxed and the money given to Joe, then let’s rock with it. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 10:55pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/145 "2010-01-21T22:55:47Z")
> [@Desert\_Nomad](#): > > I am uninsurable (pre-existing since birth). As owner of my own company I can’t be turned down as a group, but they can charge any thing they like. I was told $4700 per month for my wife and I together. That is the same as being turned down. > > Does anyone here actually pay $2350 per month for insurance? > > Note that in the last 4 decades I have spent less than $10K on medical care related to my condition. I don’t know when you left the US, but did you investigate the HSA/catastrophic coverage? ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 11:00pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/146 "2010-01-21T23:00:50Z")
> [@kunilou](#): > > **Sateryn** – forgive me for putting words in your mouth, but you seem to suggest that the solution to health care is that employers should make insurance available to their employees, and that a rational person concerned about health care should accept employment only from those organizations. > > Does that mean you expect employers to provide health insurance? Since, under your solution, employers are the gateway to health care, should all employers be required to provide insurance? If so, how would you answer \*\*Desert Nomad’s \*\*concerns? > > **Bricker** , since you believe my adult daughter should be responsible for her health care just like you are responsible for yours, does that mean you also are without insurance? If you do have insurance, do you feel that’s the best way to be responsible for your health care? If so, then would you agree that my daughter should also have insurance? If so, where should she get it from, since insurance companies refuse to sell it to her? No - as I stated above, I believe that untying insurance from employers will open up the insurance industry. Make it all up to the individual, and the groups will form themselves. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [January 21, 2010, 11:01pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/147 "2010-01-21T23:01:47Z")
> [@Clothahump](#): > > That is incorrect. If you can show us a way to provide health insurance to everyone that does NOT require John to pay Joe’s premiums, either directly or because John is taxed and the money given to Joe, then let’s rock with it. That’s not what I was saying. I’m saying that instead of thinking of what will benefit ME in the short term (I will have more money to spend), a form of UHC lets us think about what will benefit society AS A WHOLE, and will then benefit me in the long term. I may indeed have to pay (right now) for Joe’s appendectomy, but I will benefit because Joe will have good healthcare, and get back to work soon. I may be paying for Jane’s pre-natal visits, but I will benefit because her child will be healthy, and will not be a drain on the medical system in the long term. I will benefit down the line because someone will be paying for my healthcare at some point. The insurance risk is spread out over the entire population, and everyone is therefore covered. It’s good for everyone. Our per capita costs are much less than in the US, and the health outcomes are similar, if not better. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 11:03pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/148 "2010-01-21T23:03:41Z")
> [@Desert\_Nomad](#): > > I’d love to have been able to offer insurance to potential employees - since I’d get said insurance as well for my wife and I. But at $4,700 for just the two of us, and another $700 to add a (perfectly healthy, never-been-sick-ever) employee, it just isn’t going to happen. > > It was far easier to leave America and hire a foreigner (who gets insurance from his national insurance system), then buy insurance for my wife and I on the private market (which we did - we pay $200/mo - not valid in the USA). > > When I can buy full insurance in the USA for what I pay here, I’ll move home. Well, I know you’re interested in beating us over the head with this, but it seems like it’s all working out for you, despite your pre-existing condition. You went through the available options, and picked the one that worked best for you. You’ve stated many times that the current HC system has cost America jobs, but - let’s say this passes tomorrow. Do you understand that, if you move back to the US, your business will be subject to various taxes and regulations, in addition to the chunk it will take out of your paycheck? Is that preferable to you? ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 11:07pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/149 "2010-01-21T23:07:40Z")
> [@Desert\_Nomad](#): > > Shall I forward to you copies of all my “declined” letters? :rolleyes: Do you think that you shouldn’t have to pay more because of a pre-existing condition? Based on what you’ve said, your case may be a little unique, in that it apparently doesn’t cost anything, but what about a person with diabetes? It seems logical to me that those with pre-existing conditions should pay more, since they will take out more. ---
**Author:** ![mazinger\_z](https://avatars.discourse-cdn.com/v4/letter/m/5f9b8f/32.png) [@mazinger\_z](https://boards.straightdope.com/u/mazinger_z)\ **Post date:** [January 21, 2010, 11:10pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/150 "2010-01-21T23:10:54Z")
> [@CannyDan](#): > > I think you are now stretching an arguing point that is purely semantic and serves no purpose beyond registering your objection. > > We as a society require emergency care be provided to anyone who presents themselves at an emergency facility, regardless of ability to pay. So yes, in any realistically observable universe, this can be stated as a societal guarantee. Forcing the word “rights” into this debate just drags along a wealth of explicit and implicit baggage that does nothing to change the simple fact. > > Providing only emergency care does not limit a patient to one single instance of care, even for the same injury. An emergency broken arm may have further complicating emergencies in the days and weeks after first treatment, so the same injury can cause a literally unlimited number of emergency visits. Even that ACL injury referenced upthread would receive emergency treatment. If that treatment was paliative and not reconstructive (“No expensive arthroscopic surgery for you! You get a wrap and some pain meds!”) then I can guarantee the patient will return, and frequently, with further emergencies from the same original injury. Same for the kid with sniffles that gets cough medicine and a brushoff, who goes home only to return in a week with pneumonia. Note that these people are also of high risk to become disabled because of their injuries and the less-than-optimum treatment they received. They can easily be turned from poor but productive citizens to homeless wretches, at further cost to society. > > We as a society pick up the tab for this provision of emergency services, and for all of its consequences. It costs us a whopping insane amount. Look again at per capita costs in the USA versus any other first world country. We pay at least twice as much, for no better overall outcome. > > So it is disingenuous to state that we have not societally agreed to provide for our less fortunate. What can be stated, and what can be debated, is the level of financial need at which public help is triggered, the kinds and amounts of care that will be publicly provided, and the means by which public help will be gathered and distributed. > > A reasonable debate can be made about taxes, fees (including insurance premiums), single payer option, and much more. There have been a huge number of such possibilities, with permutations and combinations, proposed in the past several months of wrangling. Since it appears to the OP that the Republicans have denounced and rejected each and every single one of them, the OP asks if the Republicans have anything fresh to offer. > > So far, except for the semantic exercises above, the answer seems to be > > \ Really, the act was enacted to prevent hospitals from “patient dumping.” Ethical treatment of the sick and infirmed is a far cry from establishing a right to universal health care. ---
**Author:** ![ManiacMan](https://avatars.discourse-cdn.com/v4/letter/m/b782af/32.png) [@ManiacMan](https://boards.straightdope.com/u/ManiacMan)\ **Post date:** [January 21, 2010, 11:11pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/151 "2010-01-21T23:11:28Z")
> [@BobLibDem](#): > > To Obama’s credit, early last year he asked Republicans: “If I gave you tort reform, what would you put on the table?” His answer was chirping crickets. Seems like lots of people are saying tort reform wouldn’t do much, so I guess he doesn’t get much credit for that. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [January 21, 2010, 11:15pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/152 "2010-01-21T23:15:22Z")
> [@Sateryn76](#): > > Do you think that you shouldn’t have to pay more because of a pre-existing condition? Based on what you’ve said, your case may be a little unique, in that it apparently doesn’t cost anything, but what about a person with diabetes? > > It seems logical to me that those with pre-existing conditions should pay more, since they will take out more. Which of course means that unless they are very wealthy, people with pre-existing conditions can’t get insurance. This isn’t a good thing. I thought I should tell you that explicitly, since you don’t seem to recognize that. The system as it is now is broken for an awful lot of people. Just because you’re lucky enough to _have yours_ now, doesn’t mean there isn’t a problem. Personally, I have insurance, but I don’t let that fact blind me to the obvious. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [January 21, 2010, 11:18pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/153 "2010-01-21T23:18:03Z")
> [@ManiacMan](#): > > Seems like lots of people are saying tort reform wouldn’t do much, so I guess he doesn’t get much credit for that. Yes, but the Republicans pretend that Tort Reform and State Lines are the only two things you need to do. Their talking-heads hit those points every time someone asks what the Republican Solution is. Tort reform isn’t worth the savings (imho) and State Lines would just engender a race to the bottom as states fight each other to have the most lax insurance regulations. The bottom line is the Republican _solutions make things worse_. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [January 21, 2010, 11:21pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/154 "2010-01-21T23:21:08Z")
> [@Lobohan](#): > > Which of course means that unless they are very wealthy, people with pre-existing conditions can’t get insurance. > > This isn’t a good thing. I thought I should tell you that explicitly, since you don’t seem to recognize that. > > The system as it is now is broken for an awful lot of people. Just because you’re lucky enough to _have yours_ now, doesn’t mean there isn’t a problem. > > Personally, I have insurance, but I don’t let that fact blind me to the obvious. Please answer my question… I am not oblivious to the economic issues regarding pre-existing conditions. A lot of the defined conditions are bullshit, and the insurance industry needs to be taken to task. As a fiscal conservative, I have a lot of interest in the government funded catastrophic plans. But let’s not avoid the issue of what an individual’s duty to “the pool” is. I keep seeing it hammered that everyone has a duty to take care of everyone else - so then, doesn’t a person with a legitimate pre-existing condition owe a little more to that pool? ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [January 21, 2010, 11:23pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/155 "2010-01-21T23:23:22Z")
> [@Sateryn76](#): > > Well, I know you’re interested in beating us over the head with this, but it seems like it’s all working out for you, despite your pre-existing condition. You went through the available options, and picked the one that worked best for you. > > You’ve stated many times that the current HC system has cost America jobs, but - let’s say this passes tomorrow. Do you understand that, if you move back to the US, your business will be subject to various taxes and regulations, in addition to the chunk it will take out of your paycheck? Is that preferable to you? My business is US based, so it’ll be subject to the same regulations it is now. And since I already pay US taxes, at least then I’d be able to derive _some_ benefit. ---
**Author:** ![ManiacMan](https://avatars.discourse-cdn.com/v4/letter/m/b782af/32.png) [@ManiacMan](https://boards.straightdope.com/u/ManiacMan)\ **Post date:** [January 21, 2010, 11:24pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/156 "2010-01-21T23:24:51Z")
> [@Lobohan](#): > > Yes, but the Republicans pretend that Tort Reform and State Lines are the only two things you need to do. Their talking-heads hit those points every time someone asks what the Republican Solution is. > > Tort reform isn’t worth the savings (imho) and State Lines would just engender a race to the bottom as states fight each other to have the most lax insurance regulations. The bottom line is the Republican _solutions make things worse_. I think you meant to say that “politician’s” solutions make things worse. Wouldn’t insurance companies who dog pile into states with crappy insurance regulations basically be cutting their own throats? If the regulations are shoddy at best that would mean that their product being sold is also shoddy, and so would eventually hurt the companies bottom line. They (the insurance companies) are going to have to have a certain level of quality if they want to be profitable, right? ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [January 21, 2010, 11:28pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/157 "2010-01-21T23:28:25Z")
> [@Sateryn76](#): > > I don’t know when you left the US, but did you investigate the HSA/catastrophic coverage? I left 8 years and re-tried applying last year and was again declined by everyone - they said they could not help me with any policies they offered. Strings that when I applied for my UK-based private insurance and disclosed my condition, nothing was said except “welcome to your new policy”. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [January 21, 2010, 11:30pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/158 "2010-01-21T23:30:30Z")
> [@Euphonious\_Polemic](#): > > Even if this will lead (or has led) to higher costs per capita for your society as a whole? > Even if this will lead (or has led) to poorer health outcomes for your society as a whole? > > Does the good of the individual (i.e. you and yours) always trump the good of society? I contend that a society which requires people to be responsible for themselves will ultimately be a better society that a society which does not. So I reject the idea the good of society is in contention with the good of the individual in this case. ---
**Author:** ![LavenderBlue](https://avatars.discourse-cdn.com/v4/letter/l/e95f7d/32.png) [@LavenderBlue](https://boards.straightdope.com/u/LavenderBlue)\ **Post date:** [January 21, 2010, 11:32pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/159 "2010-01-21T23:32:32Z")
> [@Sateryn76](#): > > Please answer my question… > > I am not oblivious to the economic issues regarding pre-existing conditions. A lot of the defined conditions are bullshit, and the insurance industry needs to be taken to task. As a fiscal conservative, I have a lot of interest in the government funded catastrophic plans. But let’s not avoid the issue of what an individual’s duty to “the pool” is. > > I keep seeing it hammered that everyone has a duty to take care of everyone else - so then, doesn’t a person with a legitimate pre-existing condition owe a little more to that pool? A pre-existing condition can be defined as almost anything. Have a wart removed and you have a pre-existing condition. Go for the most minor of operations and it becomes a pre-existing condition and a reason for health insurance companies to deny you access to care that you paid for. Sigh. This thread is every bit as depressing as I imagined it would be. I hope Obama finally grows some goddamned balls, tells the Republicans to fuck off with their obstructionist nonsense and creates a bill that lets us join the civilized world on this issue. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [January 21, 2010, 11:33pm UTC](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777/160 "2010-01-21T23:33:11Z")
> [@ManiacMan](#): > > I think you meant to say that “politician’s” solutions make things worse. > > Wouldn’t insurance companies who dog pile into states with crappy insurance regulations basically be cutting their own throats? If the regulations are shoddy at best that would mean that their product being sold is also shoddy, and so would eventually hurt the companies bottom line. They (the insurance companies) are going to have to have a certain level of quality if they want to be profitable, right? That isn’t what happened with the Credit Card industry. Look, if costs are say 20% less (I’m making that number up, I’m not an insurance company) in South Dakota and you are able to sell across state lines what is going to happen? Every company will move there. Why? Because 20% off your operating costs means 20% to your profit margin. Every company that does not move to South Dakota must compete against a company that has lower costs. They will either move or be priced out of existence. For the consumer, it doesn’t matter, they have to take what they can get. So whatever shitty regulations South Dakota has become the new baseline. This has happened before, the exact same thing happened to Credit Cards. [Previous page](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777.md?page=7) [Next page](https://boards.straightdope.com/t/republicans-please-define-health-care-reform/525777.md?page=9)